More on the Role of Confusion in the Fight Against Obamacare Implementation

As I and many others have written about in the past, a big part of the fight against Obamacare implementation involves the exploitation of public ignorance about the law’s actual provisions and implications, heavily salted with misinformation. A lot more comes from the presentation of highly selective information.

The classic example is the fear-mongering about higher premiums for individual policies purchased through the new insurance exchanges. Some of this talk cherry-picks individual state analyses of early bids by insurance companies; much of it ignores the offsetting availability of tax subsidies for low-to-moderate income consumers; and virtually all of it fails to take into account that exchange policies will offer much better coverage than cheaper existing policies in states where there’s not a lot of regulation right now and that it will produce a massively better situation for people now shut out of individual markets by pre-existing conditions.

Cutting through this clatter is a new RAND study that ought to lay to rest the idea that Obamacare will create some sort of cost explosion in the individual markets, per this report from The Hill‘s Elise Viebeck:

The nonpartisan research institution simulated the effects of the Affordable Care Act on the health insurance markets of 10 states and the United States as a whole, concluding that the law will substantially decrease the number of uninsured.

On the individual market to buy health insurance, which is populated by people who do not receive coverage through their jobs, premium increases of up to 43 percent could take place in Minnesota, North Dakota and Ohio.

Health insurance premiums could decrease in Louisiana and New Mexico, researchers said, while they are likely to stay the same in Florida, Kansas, Pennsylvania, South Carolina and Texas, as well as the United States generally.

The findings challenge predictions that ObamaCare will dramatically raise premiums and make healthcare less affordable across the country.

Researchers acknowledged that premiums would increase in some states and for some individuals, such as smokers. But they concluded that tax credits to make coverage more affordable would neutralize most projected increases in out-of-pocket spending.

The truth is we won’t know the exact impact of Obamacare on purchasers of non-group insurance until the law is fully implemented, but we do know for certain sure it will address the crisis of the uninsured while improving the quality of coverage for most others in the individual markets.

But even as that debate rages, a separate line of attack on Obamacare involves the claim that employers will to a massive extent drop coverage, leaving employees with higher premium liabilities. That’s the tack taken at National Journal today by Clara Ritger, which combines the most pessimistic estimates available for premiums on the exchanges with the most pessimistic assumptions about employer behavior to create the headline: “Obama’s Affordable Care Act Looking A Bit Unaffordable.”

You can read through Ritger’s rather convoluted numbers if you wish, but her main argument is that a higher percentage of small businesses currently offering health insurance than originally anticipated may decide to dump their employees into exchanges to save themselves money at the expense of higher premiums for the dumpees. This is a very different argument than the common conservative complaint that small businesses will dump employees from full-time employment altogether in order to avoid any health insurance obligations at all. And while Ritger says her own analysis shows the potential increased costs for employees are not offset by the Obamacare subsidies, you have to accept numerous assumptions to get to the point of wondering about her numbers.

All in all, worrying about the theoretical impact of a theoretical dumping of employees by an undetermined percentage of small businesses currently offering coverage (of some quality of another) doesn’t strike me as a hammer blow against Obamacare. But it does add to the doubts and confusion underlying the shape-shifting case for repeal or delay.

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